Tooth decay is the breakdown of tooth structure by bacteria in the mouth. The bacteria in the mouth produce acids which cause tooth structure to break down. In order for tooth decay to occur there needs to be a combination of bacteria, tooth material, time and sugars (found in food). Without these four factors, tooth decay cannot occur. However, unfortunately for us, as long as we have teeth, we have the potential for decay.

Left untreated tooth decay can lead to holes in your teeth, decreased ability to chew food, pain, loss of tooth and infection (which left untreated can even lead to loss of life).

Unlike what most people believe, tooth decay does not start on the surface. Rather, the decay actually begins below the enamel, while the surface stays strong. As long as the surface of the tooth is not damaged there is a possibility that the initial area of decay will re-mineralize and will not need a filling. If the decay reaches the dentin surface of the tooth, a filling will be needed.

Our bodies will make an effort to respond to the decay once it reaches the dentin layer. It does this by trying to move the sensitive pulp further away from the decay by laying down new layers of dentin (it shrinks inwards). However, once the surface of the enamel breaks down, plaque and bacteria invade the cavity and the decay advances more quickly. At this point the patient will begin to feel sensitivity to heat, cold, acid and pressure. Eventually the bacteria will work through the dentin and into the pulp and cause a condition which is termed pulpitis (inflammation of the pulp). Therefore the old saying that ‘it is too late once it hurts', is true!

There are a number of things you can do to prevent tooth decay, remineralize your teeth and reverse early tooth decay. Remineralization can be promoted by use of fluoride (fluoride toothpaste, drinking fluoridated water, even fluoride mouth rinses can be used), removal of plaque (good oral hygiene), proper diet (a reduction in the frequency of sugar consumption), and by stimulating salivary flow (chewing sugar free gum, or sucking on sugar free candies).

Frequent visits to the dentist are extremely important in maintining a healthy smile. A dentist is able to assess tooth decay, recognize areas of early caries (reversible decay) and suggest a customized treatment.

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Dr. Jordan Klimitz practices dentistry at Klimitz Dental, a Toronto based practice operating since 1974. Dr. Klimitz teaches at the University of Toronto Faculty of Dentistry and at George Brown College department of Denturism. The staff at Klimitz Dental provide family and cosmetic dentistry in a friendly environment.